Do you set rules for your therapist?

Sorry but what does EMR stand for?

Electronic medical record, I think. Part of the ACA/Obsmacare reforms?

Because there's absolutely no downside to everyone's medical records being electronically stored.

I can relate Elio. Except I don't use therapists who have EMR systems.
In trying out new therapists a while back, it freaked me out too much.

Those notes can be used against you-in child custody cases, employment, and maybe some other rarer instances.

I was in the military before, and with certain security clearances, government investigators would actually read those notes. Although I'm no longer in the military, and had no mental health treatment prior to joining years ago, I am still very uncomfortable with this information out there. I promise I'm not a conspiracy theorist, just freaks me out thinking that yes, judgments can be made due to these records. That's only part of the reason.

Also because I don't think it's to the client's benefit to keep these notes, and often they are used to harm clients. I've had a lot of problems getting appropriate medical care when a doctor sees mental health diagnoses in my records. Worse, is the incorrect information. The EMRs should allow the client's to review the notes written about them. There's no excuse for that-it's only done for the doctor/organization's benefit.

When you get your medical records, they always withhold the doctor notes. When I've been able to get them, I found numerous mistakes and entries designed to protect the doctor from liability (omitting what I really told them and downplaying my symptoms). The innaccuracy of the notes has an adverse effect on my health care. That's what I mean by being used in ways to harm clients. I think if they made them accessible via the online portals they all have, doctors would make them much more accurate.

So the 2nd and 3rd reason is potential harm; then the principle/justice reason.

Yes, electronic medical records. I used to support the EMR at where I see my t. I was able to view my entire medical records, every note ever written in it and request corrections when I found errors. One time a MA put my pulse in as my respiration; so yes, mistakes happen all the time.

I switched jobs 3 wks ago. Losing the ability to view my medical records was one of the side affects of this job change that I had not put into play. I am not so sure had I put that into the decision making matrix, I would have left my job. Yes, I am slightly more on the paranoid side than that the general public... I think I have just reason for it. Things in ones medical records extend well beyond just medical needs.

In general, I believe in centralized medical information - I don't see mental health a purely medical condition; therefore, should not be included in centralized medical information. I also believe that a patient should have full access, rights, and abilities to have items challenged and removed from the records.

One of the big pushes right now in my part of the world is the concept of Open Notes. With Open Notes, the patient receives a copy of the progress note as written by the care provider (MA/RN/MD). However, even with this push, providers have the ability to still write notes that are removed from the Open Notes concept; they just have to take extra steps to withhold those notes. Having direct access to the record, I was always able to see exactly what was written regardless.

One of my rules was to have my t mark the notes as sensitive so that only she could see them. I did this so that others could not see what was discussed since I worked with these same people as part of my job... but also, so I could not see them. I found that I was reading them and that was not being very helpful towards building the relationship or trust; however, I couldn't stop myself from reading them. The worse was, I wasn't gaining much either from the notes - she wasn't really putting much in them and I still couldn't stop myself.

When I knew I was leaving, those last 2-3wks were really hard for me not to go look and see if she was still marking things as sensitive and if not what was there. It really triggered the whole obsessive behavior (and NO I have not told t about it and at this point have no plans to tell her). I was able to refrain ... it was a struggle and may have added to some of the anger that was going on towards her during that time period. *DUH* Ok, light bulb moment.

[QUOTE=Elio;5460218]One of my rules was to have my t mark the notes as sensitive so that only she could see them. [QUOTE]

Oh, another thing, a few weeks ago I had doc appointment for top surgery (gender alignment). I asked t if she had read the notes and she brought up the concept of my medical privacy in reverse and how come July she won't be part of this system; therefore, she won't have access to this information either. It made for an interesting discussion.

I wonder too, Elio, if your practitioners alter their note writing behavior knowing that you work there and have access to the notes.

Yes, I believe they did.

Oh man, do not get me started on EMRs. I regret ever using mh services through insurance. That s**t stays there forever, and it gets brought up at the most insensitive times. I went in for a wart removal on my hand and was asked about sui feelings. I said wtf? And the provider said they were required to ask because I had once--two years ago--said that's how I felt to a pdoc. I said then people should be told that before disclosing how they feel, and he said then people would not disclose if they were told how it would keep being brought up, and I said...um, yeah...that's why its a sh***y policy. Duh.

Anyway, I am sick about it.

I'm really sorry, ruh roh.

Drawing attention to MH issues for every provider one sees seems like the ticket to stigmatization or crappy medical care. I wonder if anyone was ever helped from this initiative?

I wish there was some kind of protection about this. In the past, I have practically begged my GP to delete depression and PTSD from my problem list. Every provider looks at that list, and it's right at the top. I don't remember even one time where listing these diagnoses helped me. Not even with PTSD where providers might be more sensitive to medical interventions.

For a few years every problem I had, any ER visit that simply reveals I am not having a heart attack, had been attributed to those issues, leading to misdiagnosis and being treated like crap.

Thanks, Skies. I don't think it's at all helpful. I stopped using insurance for mh care, but now I am forced to avoid medical care. I mean, I was stunned and humiliated to go in for a wart removal and be asked about sui thoughts. Really felt blindsided. I hardly see the point in their policy to ask patients about sui, regardless of how long ago they brought it up (and in a different treatment setting, no less). I wish I could take action, but then I would have to draw even more attention to things I would prefer to keep private.

I'm so sorry you've encountered stigma in the medical setting. But I definitely notice a reduced level of medical care due to mh diagnosis, as though complaints about physical issues aren't valid.

Interesting. I've not had a problem with my therapy an any diagnosis with other providers, but that is probably also because my pcp was the original person to urge me to go to therapy...so...

I have no idea if my T puts things in an "EMR." I have never seen her take notes, so who knows. It doesn't bother me though.

I think the problems I had were related to the fact that my diagnoses weren't obvious (required scans and tests not routinely given).

I do still have a lot of anger about this because it really contributed to my depression. Being given a treatment for depression caused a really bad depression that I still haven't recovered from.

Don't want to continue going off topic, but I feel this is a really important issue and want to warn others.

Glad to hear you haven't had problems though. I imagine others are problem free too. Just be careful because it could happen to you someday too.

Do you blame the anti-depressants for making you more depressed? Or more the fact that all those doctors got it wrong and never saw the tumor and the symptoms they caused that seemed MH-related, but weren't? I can understand that type of anger, for sure.

lack of diagnosis though AD caused some issues too (made me more tired plus disrupted my sleep)